| Purpose:he purpose of this study is to investigate the status quo of blood borne occupational exposure among nurses in a comprehensive tertiary hospital,analyze and explore the status and problems of blood borne occupational exposure,in order to improve nurses' awareness of protection,standardize the operation behavior,and provide guidance for the development of occupational protection measures.Method:From March 2016 to July 2016 in a comprehensive hospital Changchun 400 in hospital nurses by convenient sampling method as the investigation object,in the scene to investigate the occurrence and damage of the hospital based on hematogenous occupation exposure,according to literature research,expert interviews,combined with the hospital management practice of hematogenous occupation exposure,nurses for hematogenous occupation exposure with the protection of cognition,hospital protection management,nurse personal protective behavior and exposure conditions,formulate questionnaire items,in the hospital nurses within the scope of questionnaire.Data were input by Epidata3.1,descriptive analysis and single factor analysis of variance were carried out by SPSS18.0 statistical software?Result:1.basic situation of nursesAmong the 400 nurses surveyed,80.75% were female,and 19.25% were male.Age was 21~25 and 26~30 years old,24.50% and 23%,31~35 and 40 years old,respectively,18.50%?2.nurses' awareness of blood borne occupational exposure protectionThe nurse of general cognitive hematogenous occupation exposure of the highest score of 11 points,the lowest score of 4 points,the average score is 8.28 points;the theory of cognitive scores ranged from 3 to 8,the average score is 6.64 points;thehospital blood occupation exposure management cognitive scores ranged from 0 to 3,the average score is 1.47?(1)between different genders of hematogenous occupation exposure difference protection knowledge was not significant(F =0.12,P F =1.61 =0.730;theory,theory of P =0.205;F =0.87 P management,=0.350 Management);there are significant differences between different age three cognitive(F total =14.87 P <0.001;F on =9.59,P <0.001 F =7.71 theory;management,P management,<0.001)over the age of 31 nurses in basic theory of cognition and protection of hospital exposure to blood borne occupation occupation exposure management knowledge and general knowledge are in good condition;the cognitive level of 31 to 35 year old age group was the highest.(2)no significant differences in the degree of general cognitive and cognitive theory(F =2.03,P F =0.26 =0.109;P theory,theory of =0.858),but significant differences on the knowledge of hospital management cognition(F management=3.98 P management =0.008),undergraduate and postgraduate degree than college and secondary school students.(3)there are significant differences in different departments of general cognition and the basic theory of cognition(F =7.37,P F =9.18 <0.001;P <0.001 theory;theory);two average scores were higher than those in other emergency departments,the average score of at least for hospital specialist,cognitive occupation exposure related knowledge management,difference is not obvious between different departments(F management =0.93,P management =0.427).(4)there were significant differences in the three cognitive status of different titles(F total =6.98,P total <0.001;F theory =7.35,P theory <0.001;F management=5.74,P management <0.001).The nurse in charge of or above the nurses exposed to blood borne occupation cognition related management knowledge and theory of cognition,on the overall hospital door,significantly higher than that of other titles,three cognitive practice nurses were the worst.(5)there are significant differences between different age(data were F =13.25,P F =9.53 <0.001;theory,P theory <0.001;F management =6.36,P management<0.001)),of which more than 4 years seniority nurses in hematogenous occupation exposure related management knowledge and the cognitive theory of general cognitive hospital door and were well below 1 years seniority nurses were poor three cognitive?3.protective behaviors of blood borne occupational exposure among nurses(1)general protective behavior of nurses76% of the nurses received the corresponding vaccine;94.25% in the treatment of nurses were more concerned about whether patients carry pathogens;nurse hematogenous occupation exposure protection knowledge mainly comes from the hospital(52%)education and work experience(16.50%);that they have the perfect hematogenous occupation exposure protection knowledge of nurses accounted for only 53.75% of the nurses;that familiar with hematogenous occupation exposure accounted for 68.25% of the reporting process?(2)daily diagnosis and treatment behavior of nursesThe blood in daily nurse occupation exposure treatment behavior investigation:in routine diagnostic operation not in accordance with the standard of occupation protection norms operate more,contact with blood and body fluids may splash patients wear goggles,masks,gowns,meet the ratio is only 40.38%.The standard is used needle injection and blood vessel into the canal,a special hard leakage in(98.65%),sharp injury after extrusion after hemorrhage(97.12%),thorough cleaning and disinfection of skin and mucosa stained with blood or body fluid cleaning immediately(96.15%),medical items with blood or body fluid contamination with disinfectant(93.85%)etc?4.blood borne occupational exposure among nursesIn the past year,there were 235 nurses who had blood borne occupational exposure,accounting for 58.75% of the total.Among them,66.81% nurses reported exposure 1~3 times,and 22.98% nurses had 4~5 times.The locations of exposure were from operation room to(44.26%),outpatient(34.47%),ward(13.62%),and others(7.66%).41.70% of the nurses who reported blood borne occupational exposure were not reported,and 35.04% of them were reported more than 24 hours later.The main reasons for not reporting were not knowing whom to report(46.94%),and 28.57% of the nurses thought they didn't know it should be reported.54.04% of the nurses did not adhere to regular monitoring and follow-up?5.Measures to prevent occupational exposure in hospitalsIn terms of organizational protection training,64.25% of the hospitals were regularly organized,representing 28.50% of occasional organizations,indicating that7.25% had never been organized.Nurses believed that the hospital attached importance to occupational infection and occupational protection accounted for 38.50% of the total,indicating that the general attention,not much attention were 35%,15.50%,and another 11% of the nurses think the hospital does not pay attention to.Among the surveyed nurses,it was considered necessary to prevent occupational protection training(89%).When asked about how to obtain occupational exposure knowledge,most nurses want to obtain hospital training(91.75%),and 77.50% and 71.75% of nurses hope to obtain training through department training and learning within the hospital network?Conclusion:1,the hospital in the protection of education and training investment and hospital blood borne occupational exposure protection rules and regulations of the propaganda and interpretation is not enough,the hospital education and training scattered,limited,non-standard,did not form a feasible education system.We should pay attention to the management of hospital protection,establish and improve the management system of blood borne occupational exposure,improve the professional knowledge education system of blood borne occupational exposure protection for nurses,and cultivate nurses' stable protective behavior.2,the lack of knowledge and system of blood borne occupational exposure protection is a prominent problem,especially the specific details of clinical protection is poorly understood.We should strengthen the implementation of the operation standards in the field control,build a safe medical environment,strictly implement the operation standard,implement the standard protection measures,set up on-site supervision personnel,and supervise the quality of occupational protection.3,the nurse's overall blood borne occupational exposure protection is not optimistic,protection behavior is not standardized is a prominent problem.After blood borne occupational exposure,the reporting process should be simplified,the monitoring of blood borne occupational exposure should be strengthened,and the monitoring and feedback system of blood borne occupational exposure protection should be established to establish the psychological intervention mechanism and follow-up system after the occurrence of blood borne occupational exposure.4,the formulation of blood borne occupational exposure protection standard is the key to reduce sharp instrument injury,through legislation to relieve the nursingstaff blood borne occupational exposure worries. |
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